Recovery of aphemia with pure word dumbness after treatment with repetitive transcranial magnetic stimulation: A case report. (August 2021)

• Record Type: Journal Article
• Authors: Rao, Jiang; Hu, Guanjie; Yang, Wenjie; Yu, Jiawen; Xue, Chen; Tian, Li; Chen, Jiu
• Is Part Of: Journal of neurolinguistics. Volume 59(2021)
• Publication Date: 2021-08
• Subjects: Aphemia -- Broca's area -- Oral express disorder -- Pure word dumbness -- Repetitive transcranial magnetic stimulation; MRI magnetic resonance imaging -- rTMS repetitive transcranial magnetic stimulation -- TR repetition time -- TE echo time -- TI time inversion -- FA flip angle -- DPABI Data Processing and Analysis of Brain Imaging -- SPM Statistical Parametric Mapping -- GM gray matter -- WM white matter -- CSF cerebrospinal fluid -- FWHM full width at half-maximum -- ReHo regional homogeneity -- KCC Kendall's coefficient concordance -- DC degree centrality -- FC functional connectivity -- SPSS Statistical Package for the Social Sciences -- ROIs regions of interest; Neurolinguistics -- Periodicals; Language and languages -- Physiological aspects -- Periodicals; Psycholinguistics -- Periodicals; Brain -- physiology -- Periodicals; Language -- physiology -- Periodicals; Neurolinguistique -- Périodiques; Langage et langues -- Aspect physiologique -- Périodiques; Psycholinguistique -- Périodiques; Language and languages -- Physiological aspects; Neurolinguistics; Psycholinguistics; Periodicals; Electronic journals; 616.855
• DOI: 10.1016/j.jneuroling.2021.100991
• Languages: English
• ISSNs: 0911-6044

Abstract

Abstract: Aphemia with pure word dumbness is a relatively rare clinical syndrome caused by injury to the Broca area of the dominant hemisphere. Patients with this syndrome have significant difficulties in oral expression, whereas other language functions, such as written expression and comprehension, are normal. In this study, a patient without no evidence of structural brain lesions presented with aphemia with pure word dumbness after head trauma of the frontal lobe. Through magnetic resonance imaging (MRI) examinations, functional abnormalities (regional homogeneity, degree centrality, and language network) were found in the patient without structural alterations. After four weeks of treatment with repetitive transcranial magnetic stimulation (rTMS) and cognitive evaluation every week, we found that the patient's linguistic function (i.e., spontaneous speech, speech comprehension, rehearsal, naming, reading, writing and the aphasia quotient) recovered gradually. Therefore, rTMS may be an adjuvant therapy for the recovery of aphemia patients with pure word dumbness. Highlights: A patient without organic disease presented with aphemia with pure word dumbness after following head trauma to the frontal lobe. The patient's ability to speak recovered gradually after four weeks of treatment with rTMS. Aphemia with pure word dumbness without structural abnormalities may be a disease with functional disorders in Broca's area. Aphemia patients with pure word dumbness may recover speech function due to the recovery of the language function network. This report provides new insights and treatment for aphemia patients with pure word dumbness.